"It's Hard Hard to Hard to Make It That Way. But You Gotta Make It All Different Levels": Making Aphasia Groups Work From the Perspective of People With Severe Aphasia.

PURPOSE: Facilitators require further guidance on best practices to support people with severe aphasia (PWSA) who attend their aphasia groups. In this study, we position PWSA as experts who can inform future research and practice patterns. The aim of this study was to explore the ideas PWSA have regarding how aphasia groups should function with a specific focus on aspects that relate to meeting their needs, given the severity of their aphasia. METHOD: We analyzed data from interviews with five PWSA that were completed as part of a larger project. For this study, we used qualitative content analysis with a descriptive explorative approach, grounded in a constructivist paradigm. This approach seeks low-inference interpretation to richly describe experiences, events, and processes in an accurate and easy to understand manner. RESULTS: Findings highlight two main categories, group makeup and supported group interaction, as key factors in the aphasia group experience for PWSA. We identified five secondary and 15 further embedded subcategories capturing how decisions and behaviors of facilitators and other group members impact the experience of PWSA in aphasia groups, as well as how varied tools are required to support them in different contexts. DISCUSSION: Participants' insights highlight the dynamic characteristics of aphasia groups, as they shared that specific approaches or supports should be implemented in one context while another decision should be made when the context changes. Perspectives of PWSA captured in this project provide groundwork for continued research that is informed by community members' values and needs while providing immediate insight that practicing facilitators can consider implementing in the groups with which they work. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33230481.